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hypertensive emergencies

Anne-Maree Kelly, Sharon Klim
BACKGROUND: To determine the rate of all cause and cardiac death, new myocardial infarction (MI) or coronary revascularisation at over three years from index visit in emergency department chest pain patients without known coronary artery disease (CAD) at index presentation who had a negative electrocardiogram (ECG) and biomarker workup for acute coronary syndrome (ACS). METHODS: An unplanned sub-study of a prospective observational study of consecutive adult patients presenting to the ED with atraumatic chest pain (or equivalents)...
September 13, 2016: Heart, Lung & Circulation
Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
Brent M Egan, Bo Kai, C Shaun Wagner, Douglas O Fleming, Joseph H Henderson, Archie H Chandler, Angelo Sinopoli
Apparent treatment-resistant hypertension (aTRH) may confound the reported relationship between low blood pressure (BP) and increased cardiovascular disease (CVD) in treated hypertensive patients. Incident CVD was assessed in treated hypertensive patients with and without aTRH (BP ≥140 and/or ≥90 mm Hg on ≥3 medications or <140/<90 mm Hg on ≥4 BP medications) at three BP levels: 1: <120 and/or <70 mm Hg and <140/<90 mm Hg; 2: 120-139/70-89 mm Hg; and 3: ≥140 and/or ≥90 mm Hg. Electronic health data were matched to emergency and hospital claims for incident CVD in 118 356 treated hypertensive patients...
October 21, 2016: Journal of Clinical Hypertension
Jiaan-Der Wang
As life expectancy greatly increases in persons with hemophilia (PWH), more age-related diseases such as cancer and cardiovascular disease (CVD) emerge among this patient group. The aim of this study was to review the available evidence on the epidemiology of CVD events, and incidence and survival of cancer in PWH. The prevalence of CVD events among PWH seems to be similar to that of the general population. Some known risk factors for the event, including aging, hypertension, and hyperlipidemia, are also associated with its occurrence in PWH...
2016: Thrombosis Journal
Eric Klingelhoefer, Hendrik Bergert, Stephan Kersting, Stefan Ludwig, Norbert Weiss, Frank Schönleben, Robert Grützmann, Gabor Gäbel
BACKGROUND: Peripheral arterial disease (PAD) is one of the most underestimated diseases because of its high prevalence and unfavorable prognosis. Many PAD patients without suitable autologous veins or options for endovascular treatment receive prosthetic above-knee femoropopliteal bypass (PAKB). Until now predictors of prosthetic bypass failure and of increased amputation risk remain indistinct. This study aimed to identify predictive factors associated with better bypass patency and limb salvage to achieve a more favorable outcome after PAKB reconstruction...
August 2016: Journal of Vascular Surgery
Andrea Gruneir, Lauren E Griffith, Kathryn Fisher, Dilzayn Panjwani, Sima Gandhi, Li Sheng, Chris Patterson, Amiram Gafni, Jenny Ploeg, Maureen Markle-Reid
OBJECTIVE: To characterize comorbid chronic conditions, describe health services use, and estimate health care costs among community-dwelling older adults with prior stroke. METHODS: This is a retrospective cohort study using administrative data from Ontario, Canada. We identified all community-dwelling individuals aged 66 and over on April 1, 2008 (baseline), who had experienced a stroke at least 6 months prior. We estimated the prevalence of 14 comorbid conditions at baseline; we captured all physician visits, emergency department visits, hospital admissions, home care contacts, and associated costs over 5 years stratifying by number of comorbid conditions...
October 19, 2016: Neurology
I-Shiang Tzeng, Su-Hsun Liu, Kuan-Fu Chen, Chin-Chieh Wu, Jih-Chang Chen
To reduce patient boarding time at the emergency department (ED) and to improve the overall quality of the emergent care system in Taiwan, the Minister of Health and Welfare of Taiwan (MOHW) piloted the Grading Responsible Hospitals for Acute Care (GRHAC) audit program in 2007-2009.The aim of the study was to evaluate the impact of the GRHAC audit program on the identification and management of acute myocardial infarction (AMI)-associated ED visits by describing and comparing the incidence of AMI-associated ED visits before (2003-2007), during (2007-2009), and after (2009-2012) the initial audit program implementation...
October 2016: Medicine (Baltimore)
Almotasembellah Aljaafareh, Jose Ruben Valle, Yu-Li Lin, Yong-Fang Kuo, Gulshan Sharma
OBJECTIVES: Long-acting bronchodilators are mainstay treatment for moderate to severe chronic obstructive pulmonary disease. A growing body of evidence indicates an increased risk of cardiovascular events upon initiation of these medications. We hypothesize that this risk is higher in patients with chronic obstructive pulmonary disease who had a preexisting cardiovascular disease regardless of receipt of any cardiovascular medication. METHODS: A retrospective cohort of patients with a diagnosis of chronic obstructive pulmonary disease based on two outpatient visits or one inpatient visit for chronic obstructive pulmonary disease (International Classification of Diseases, 9th Edition, Clinical Modification codes 491...
2016: SAGE Open Medicine
John J B Anderson, David C Nieman
The Mediterranean diet is upheld in the 2015-2020 Dietary Guidelines as an example of an eating pattern that promotes good health, a healthy body weight, and disease prevention throughout the lifespan. The Mediterranean eating pattern is based on a variety of unprocessed plant foods including fruits, vegetables, whole grains, legumes, nuts, and seeds that are high in polyphenols. The majority of polyphenols arrive in the colon where bacteria degrade them into smaller phenolics that can be translocated via the portal vein to the liver...
October 14, 2016: Nutrients
Teba Alnima
Electrical carotid baroreflex activation therapy is an emerging device-based treatment for patients with treatment-resistant hypertension. Its blood pressure lowering effect has been demonstrated in several animal and human studies. In addition, this treatment has showed its prolonged effect over the long-term. The main mechanism of the blood pressure reduction during this therapy is by inhibition of the sympathetic outflow. Yet the question arises whether the inhibition of central sympathetic activity is sufficient to be the sole mechanism behind the sustained reduction in blood pressure...
September 2016: Journal of Hypertension
Adriana Van Ballegooijen
Cardiovascular disease and osteoporosis are major age-related causes of morbidity and premature death that occur among older adults. Emerging evidence suggests that calcium from bone is deposited in the arteries. This leads to calcification in valves and vessels, which is associated with a 3-4 fold higher risk of coronary heart disease. Calcium and vitamin D supplementation is frequently advised in older adults for the prevention of osteoporosis and to reduce the risk of fractures and falls. However, recent RCT's showed that individuals taking calcium and vitamin D were at higher risk of cardiovascular disease...
September 2016: Journal of Hypertension
Fadi Charchar
Coding regions of the genome account for less than 2% of the entire human DNA. Our hypothesis is that genetic mechanism besides coding genes are likely to contribute to BP regulation. Non-coding RNAs (ncRNAs) are emerging as key players of transcription regulation in both health and disease states. They control basic functions in virtually all cell types relevant to the cardiovascular system and, thus, a direct involvement with BP regulation is highly probable. Here I review findings on both short and long RNA in human hypertension and the renin-angiotensin system...
September 2016: Journal of Hypertension
Jinho Shin
Arterial pulsation which had long been studied for estimation of blood pressure or mean blood pressure was replaced by the measurement of systolic and diastolic blood pressure using Korotkoff sound detected by stethoscope in the beginning of the previous century. In the meantime, vast of modern knowledge of human hypertension from epidemiology to randomized clinical trial had been built on the Korotkoff sound and stethoscope methodology. Hypertension is very special clinical entity in terms of the diagnosis is solely dependent on the manual blood pressure measurement by a physician or nurse...
September 2016: Journal of Hypertension
Lin Shi
According to the seventh report of Joint National Committee (JNC 7), hypertensive emergency (HE), a kind of hypertensive crisis, is defined as a sudden and abrupt elevation in blood pressure so as to cause acute target organ dysfunctions, including central nervous system, cardiovascular system or kidneys. Patients with HE require immediate reduction in markedly elevated blood pressure. Currently, there are no international guidelines for children HE, so the JNC definition is commonly used. Hypertensive emergency in children is rare but a life-threatening emergency...
September 2016: Journal of Hypertension
Peter F Davies, Elisabetta Manduchi, Christian J Stoeckert, Yi-Zhou Jiang
Hemodynamics creates a constantly changing physical and chemical environment to which the arterial endothelium is exquisitely sensitive. Biomechanical stresses are intrinsic to blood flow characteristics and blood pressure and therefore are important considerations in hypertension. Near branching anatomical sites in arteries, blood flow separates from the main flow to undergo complex multi-directional characteristics for a part of each cardiac cycle (collectively referred to as disturbed flow). Atherosclerosis and aneurysmal pathology develop preferentially at disturbed flow locations, particularly when an additional cardiovascular risk factor such as hypercholesterolemia or high blood pressure are present...
September 2016: Journal of Hypertension
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Levon Kocharyan, Lilit Baghdasaryan
OBJECTIVE: About 40% of adult population suffers from arterial hypertension and its complications are in the leading places among overall and cerebrovascular mortality. Despite the broad range of available medications and its combinations, less than half of the patients have adequately controlled blood pressure worldwide. And arterial hypertension has a great social and economic impact. Our goal was to create a program which will give an opportunity for long term control of arterial hypertension and closer follow up...
September 2016: Journal of Hypertension
Kristi Reynolds, Daichi Shimbo, C Barrett Bowling, Luqin Deng, Adam Bress, John Sim, Paul Muntner
OBJECTIVE: To identify risk factors for serious fall injuries following initiation of antihypertensive medication among older adults. DESIGN AND METHOD: We conducted a retrospective cohort study using a 5% random sample of people with Medicare health insurance, a government program for older US adults. The analysis was restricted to patients with a diagnosis of hypertension who initiated antihypertensive medication between 2007 and 2011. Initiation was defined by the first antihypertensive medication fill in this time period preceded by 365 days with no antihypertensive medication fills...
September 2016: Journal of Hypertension
Mi-Na Kim, Young-Beom Kim, Seong-Mi Park, Yang In Kim, Wan-Joo Shim
OBJECTIVE: Estrogen has cardio-protective effect via several peripheral mechanism. But its action on central nervous system has not been fully investigated. Estrogen receptors are expressed in the hypothalamic magnocellular neurons, secreting vasopressin. In the male-rat models of DOCA-salt, GABA functions as an excitatory, rather than inhibitory neurotransmitter in vasopressin neurons. It might contribute to the development and maintenance of hypertension. In the current study, the effect of estrogen on central GABA action was investigated in the female rat models...
September 2016: Journal of Hypertension
Zhendong Liu, Yingxin Zhao, Yuanli Dong, Biao Lu, Miaomiao Wei
OBJECTIVE: To explore the effects of Helicobacter pylori infection on atherosclerosis in patients with hypertension and type 2 diabetes mellitus (T2DM). DESIGN AND METHOD: 228 subjects (Mean age: 67.92 ± 7.51) were enrolled in this study. Whether or not did the patients infected with Hp by 14C-Urea Breath Test (14C-UBT). The participants were divided into infection-positive group and infection-negative group basing on the outcomes of 14C-UBT. Their Carotid-Radial pulse wave velocity(CrPWV) and Carotid intima media thickness(CIMT) were mornitored...
September 2016: Journal of Hypertension
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